Introduction: Ventilator-associated pneumonia, a common cause of mortality and morbidity, is commonly seen among patients with endotracheal intubation due to unsafe suctioning practices by health professionals. Objective: A systematic review was conducted to explore the gaps in the existing practices of nurses and thus proposing comprehensive guidelines for safe practice. Materials and methods: A two-phase strategy was adopted to identify the studies through a comprehensive electronic search in PubMed, Google Scholar, ProQuest, Ovid, and Helinet Summon by using predefined keywords within a year limit of 2002-2016. The quality of studies was reviewed using tools endorsed by Joanna Briggs Institute. This review was conducted according to the guidelines described in the preferred reporting items for systematic reviews and meta-analyses (PRISMA). Qualitative data were described through the process of metasynthesis. Quantitative analysis was performed to combine the competent quantitative evidences to identify knowledge and practices of endotracheal suctioning (ETS). Results: Thirty studies had been subjected for metasynthesis, among which six provided relevant information for quantitative analysis. Quantitative analysis of the studies reported that only 36% of the nurses had assessed patients prior to suctioning and had knowledge about the size of the suction catheter while only 46% were aware of the appropriate suction pressure to be used for ETS. Handwashing compliance prior to suctioning was observed in only 62% of the nurses. It is reported that, despite the awareness on possible complications, nurses fail to adhere to the recommended practice guidelines. Conclusion:The current review would explore the best evidence-based practices (EBPs) among nurses related to ETS, which would ensure quality care to critically ill patients.

Abstract:Psychosocial risk factors significantly contribute to the morbidity and mortality of patients with cardiovascular disorders. The present study explored the anxiety and depression status of patients with coronary artery disease and evaluated the effect of deep breathing exercise on these psychosocial variables as well as physiological variables like heart rate variability and blood pressure. A randomized control design was adopted for the study. Out of 65 clients eligible for the study, 45 were selected based on inclusion criteria. Patient were trained in Deep breathing exercise (DBE)for 2-3 days, were instructed to practice the exercise twice a day for 10 min for a period of 2 weeks, further instructed to come for follow up to cardiac OPD after 2 weeks. The study findings revealed that majority of the cardiac patients were anxious 39 (86.66%), 23(57.5%) had mild depression and 3(7.5%) were with severe depression. Fischer's exact test revealed a significant association between depression and occupation (p=0.051), monthly income (p=0.031) and co morbid disease (p=0.006, p<0.05). Karl Pearson's correlation coefficient revealed significant positive correlation between anxiety and depression i.e. (r = 0.414, p <0.01). DBE was found to be effective in reducing anxiety and diastolic BP of clients with CAD. But there was no significant reduction in HR, SBP and depression after the intervention.

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Background: Cancer is one of the ten leading cause of death in India. Cancer patients usually present with moderate to severe pain which results usually from the cancer itself or from their treatment .To counteract pain complementary therapies are used along with the medical treatment. The most common used in the clinical setting is Music therapy; which is found to have a positive effect on the physical and psychological response of the patients. Objectives: To find the effectiveness of Music therapy on Pain and Quality of life among Cancer survivors. Material and Method : A quasi experimental research design was adopted for the study. The data were collected using demographic proforma, Numerical Pain rating scale and McGill Quality of life Questionnaire. 50 subjects with moderate to severe pain were identified and were randomly allocated into experimental (25) and control group (25). Experimental groups (25) received Music therapy for 15-20 mins twice a day for a period of 5 days. The control group (25) received no intervention. Pain was assessed twice a day, before and after the intervention for 5 th th days and QoL was assessed on the 6th and 10th day for both the groups.. Results: Majority of the subjects19 (38%) were between the age groups of 41-50 years and most of them 29 (58%) were males. Among the females the most common cancer was breast 12 (24%) and among males it was lungs 10 (20%). Most of the subjects 23(46%) had stage –II cancer, and 28(56%) were on radiation therapy. With regard to treatment, majority 29(58%) were on treatment for a duration of 1-3 months. The study also revealed a significant difference in the level of pain after the music intervention (p<0.05) and a significant improvement in the Quality of life especially affecting the physical and psychological domain (p<0.05). No significant association was found between pain, QoL and selected demographic variables (p<0.05) Conclusion: Music therapy was found to be an effective complementary therapy in reducing the level of pain and improving the QoL of the cancer survivors.